Texas Health backs off statement blaming EHR flaw for missed Ebola diagnosis

Written by Helen Gregg for Becker’s Health IT & CIO Review

Texas Health Resources has backtracked on a statement released Thursday that said a workflow flaw in the EHR led to a missed Ebola diagnosis at Texas Health Presbyterian Hospital Dallas.

The patient, Thomas Eric Duncan, presented at the hospital’s emergency department Sept. 25. He was sent home, but returned three days later by ambulance and tested positive for Ebola. He was placed in isolation and is currently in critical condition.

Arlington-based Texas Health Resources has since been criticized for not making the diagnosis on Mr. Duncan’s initial visit and not placing him under quarantine, potentially exposing people he came into contact with between hospital visits to the deadly virus.

On Thursday, the health system released a statement explaining even though the nurse who initially saw Mr. Duncan recorded his recent travel to West Africa into the hospital’s Epic EHR, that information was not available in the physician’s EHR view. Subsequently, Mr. Duncan was not tested for Ebola on his first visit or placed into isolation.

“We have identified a flaw in the way the physician and nursing portions of our EHR interacted in this specific case,” according to the statement. “The documentation of the travel history was located in the nursing workflow portion of the EHR, and was designed to provide a high reliability nursing process to allow for the administration of influenza vaccine under a physician-delegated standing order. As designed, the travel history would not automatically appear in the physician’s standard workflow.”

However, late Friday the health system went back on this statement, releasing a statement that said the patient’s travel history was available within the physician’s workflow. “There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event,” according to the statement, offering no further explanation.